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Quebec Health Minister Rejean Hebert responds to reporters questions before entering a party caucus meeting Tuesday, April 23, 2013 at the legislature in Quebec City.Jacques Boissinot/The Canadian Press

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Members of the Quebec National Assembly have just completed two days of hearings on the wisdom of water fluoridation.

You can be forgiven for thinking that the province is caught in a time warp because this issue was resolved – scientifically at least – more than 60 years ago. When fluoride is added to water, cavities drop from 20 to 40 per cent.

During the last provincial election campaign, the Parti Québécois promised to ban water fluoridation. After the PQ victory, anti-fluoridation groups petitioned for and obtained a parliamentary commission. Thankfully, Health Minister Réjean Hébert has said clearly that fluoridation is a sensible health measure so the hearings are largely a delaying tactic and nothing will happen, aside from giving a platform to quackery, of course.

Only 3 per cent of Quebeckers currently have fluoridated water flowing from their taps so this is hardly a burning issue. (By contrast it's just over 70 per cent in neighbouring Ontario and 50 per cent nation-wide.)

If anything, the Quebec public should be demanding to know why they don't have broader access to this effective public health measure. It's no coincidence that Quebec children have the highest rate of dental caries in the country. They also have public dental insurance for children, so a fiscally minded government should insist on fluoridation – but logic in public policy is not always what we should expect.

At the commission, anti-fluoridation groups presented four principal arguments, which were summed up nicely by Valérie Borde of L'actualité magazine:

  • Fluoride is a “chemical” that is poisoning people;
  • By putting fluoride in municipal water people are being treated against their will;
  • Adding fluoride is a waste of tax dollars because most of it ends up back in nature;
  • There is a growing scientific “controversy” about the safety of fluoride.

None of these arguments hold any water (fluoridated or otherwise). Like the anti-vaccine movement, the anti-fluoride movement is fuelled by a strange mixture of pseudo-science, chemophobia and paranoia.

Fluoride, in small quantities (0.7 milligrams per litre of water is the standard) is perfectly safe and it prevents cavities. It is one of many sound public health measures, such as ensuring drinking water is free of pathogens and adding folate and vitamin D to food. Adding fluoride to water is indeed more expensive than not doing so – a little less than $1 per person a year – but, in the grand scheme of things, it is a pittance. Take a look at any municipality's budget and you will find far more inane spending. Finally, the only controversy is one manufactured in cyberspace by opponents; there is little serious scientific debate.

The first community to fluoridate its water was Brantford, Ont., in 1945. It was paired with Sarnia, which did not have fluoridated water, for an 11-year case study. Over that period, Brantford saw a 35 per cent reduction in cavities.

The U.S. Centers for Disease Control and Prevention calls fluoridation one of the 10 greatest public health achievements of the 20th century. It's cheap and effective, with little downside.

The only danger posed by fluoride is fluorosis – excessive consumption can cause staining of the teeth but that cosmetic problem is easily countered. Fluorosis tends to occur in those who use toothpaste containing fluoride and swallow it, not because they drink water. (That's why young kids should use fluoride-free toothpaste – if they are drinking fluoridated water.) The arguments that fluoride in drinking water lowers IQ, leads to more bone fractures, impairs reproduction and so on are not based on evidence.

One of the larger questions here is what politicians should do when they make stupid promises? In this case, the PQ prolonged the idiocy by holding two days of parliamentary hearings and giving credence to groups espousing dubious theories.

If they truly want to advance public health, surely the time of politicians could be better spent than studying fluoridation. Say, for example, studying the health problems caused by growing income disparities.

Because, ultimately, fluoridation is a public health measure that helps everyone in the community, regardless of socio-economic status. It helps poor kids avoid cavities as much as middle-class and rich ones. And we need more programs that promote equity, not fewer.

André Picard is The Globe and Mail's health columnist.

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